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TATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY RECEIb'ED <br />Department of Natural Resources <br />7373 Sherman 6t., Room 275 <br />Denver, Colorado 80203 JUL 0 3 2002 DIVISION O F <br />Phone: (303) 866-3567 MINERAL S <br />FAX: (303) 832-8106 & <br />pivision of Minerals and Geology G E O L O G Y <br />CONSTRUCTION MATERIALS a E c t. A M A n o N <br />MINING•SA FETY <br />• REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />CHECK ONE: ~ New Applicafion (Rule 1.4.5) ~ Amendment Application (Rule 1.1 khael B. Long <br />~ivision Director <br />Conversion Applicafion (Rule 1.11) <br />Permit # M - 19 _ 88 _044 (provide for Amendments and Conversions of existing permits) <br />The application for a Construction IvIaterials Regulaz 112 Operation Reclamation Permit contains three major pazts: (1) the application form; <br />(2) Exhibits A-S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stabi]ityExhibit; and (3) the application fee. When yvu submit your <br />application, be sure to include one (1) complete siened and notarized IVORY ORIGINAL and four (4) copies of me completed Ivorv <br />application form, five (5) copies of Exhibits A-S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stabi]iryExhibit, and a check for the . <br />applicaton fee described under Secfion (4) below. Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 lY2" X 11" <br />or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this forrrL <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />1. AaaGcanUoaerator or comaany name (name to be used on oetmitl: Schmidt Construction Company <br />1.1 Type of organization (corporation, pazmership, etc.): COrporati0n <br />1.2 I.R.S. Tax I.D. No. or Social Security Number: <br />2. Operation name foil, mine or site name); <br />Coal Creek Resources <br />3. Permitted acme new or_existinE site): <br />3.1 Change in acreage (+) <br />3:2 Total acreage in Permit area <br />4. Fees: <br />4.1 New Application ~ - <br />4.2 New Quarry Applicafion <br />4.4 Amendment Pee <br />4.5 Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined: Sand <br />5.1 Incidental commoditie(s) to be mined: 1. - Ibs/pons/vr <br />3. / lbs/Tons/vr 4. / lbs/I'ons/vr <br />1550.00 permitted acres <br />-22.50 acres <br />1527.50 acres <br />$2.344.00 application fee <br />$2.906.00 quarry application <br />$1.938.00 amendment fee <br />$2.344.00 conversion fee <br />2. / Ibs/I'ons/vr <br />5. / lbs/fons/vt <br />5.2 Anficipated end use of primary commodite(s) to be mined: COnStruCtlOri aEt?'1'egate <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: N/A <br />